HomeMy WebLinkAboutMechanical Permit 14. 0484 5 0 0\3\
i o o 0 § 2222-n 5 8 ��
z� o o
tri / 0 xi xi o o k 2.m / �§ �z 73 z co -'
% t -4 -1q 2 CO � Qq ® P z-
0 0 ■ - m z 0 z o
% k § o ►� - -"� 2 §�
% o g > 0 ` On m
r § 7
m o lo xi lb
f § o o 000QOO
3roo -1 z a a §/ 1�ni /
$ 2 f - 'n § 2M % § m p 0
, q m -, q
1 I. N., z § xx z ■ z x
AoZ § § - § vq r �
\ 2 $ , ' ; cc z r
■ f r- -o 0
I
0 ■ 7
0
2 A ❑ O ❑ QOO .� �
R. > B Tokkk§ (31
§
• 2 '♦ L. � � to ® �
4 rn � MMZ �
m Al -n ■ � F -
it - ■
4r § , In
00 "Ips CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
u
�I 2P
I.Pink File PERMIT NO.
NNESO 2.Green App /, / 9��
3.Yellow Applicant � .
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
00 (clrilbrid9e (7 '(e ( RILO
LEGAL DESCRIPTION (flIce u.s onl
:ks.
LOT / BLOCKP/AIION�CT /52 -
�cl PID �� 00 f vol-a
(Nae)Ri k=v)t( ritT j/ �l 59Z ��yy'
(Phone) 767
(Add
ress)(e0ll.) Onlor d' Circle SL> l t' 55-- 71NPP e CAN r/i) �� C6 1avvifia'i (Phone�5Z `T5
(Address) 2C 2Lh , (Y(buY Doe J6v irsi !Fiji 55,
(Contact Person) LLi1c/I (Phone) r„q � Q/ 7
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTIONI EPL CEMENT ALTERATIONS
FURNACE MAKE AND MODEL CONSTRUCTION ‘..DID,
k- L 2 �I-Z�� FUEL NCS
FLUE SIZE RETURN OPENINGS INPUT pO,C JLJJ OUTPUT 1 c
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into Required Side Yard Setbacks.
❑Mechanical ❑Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑Special Devices Cantilevers to the Outside of Buildings
❑Vent. System ❑Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial&Multi Family 1%of job cost Residential,Gas Fireplace $49.50
$49.50 minimum
Residential, Heating&A/C (New Construction) $149.50 Residential,Additions &Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
Cost$ Buildinermit#
HEATING PERMIT FEE $ I
STATE SURCHARGE $ ,p
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved ,►0 („1A..,:c0 Receipt No. .7)40
Building Official Date Date 4 `6^ q 5.,k,-- )0 By
24 hour notice for all inspections (952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372